Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body

Cavel, Oren; Bergeron, Mathieu; Garel, Laurent; Arcand, Pierre; Froehlich, Patrick

doi:10.1016/j.ijporl.2011.11.002

Cited by 32 publications

(41 citation statements)

References 37 publications

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“…Children may inhale objects without adult supervision. We demonstrated that even witnessed aspiration had a very high sensitivity (96%) but a low specificity (18%), which is in accordance with previous reports [4,5].…”

Section: Discussionsupporting

confidence: 93%

“…Cough and stridor had very high sensitivities (94% and 97%, respectively), whereas the specificities were low (23% and 5%, respectively). No parameters were found to be both sensitive and specific; similar results were reported by Cavel et al [5]. CXR in the posteroanterior (in younger children: anteroposterior) and lateral projections is a basic radiological examination [1,14,20].…”

Section: Discussionsupporting

confidence: 79%

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Diagnosis of paediatric airway foreign body: is it easy?

Rybojad¹,

Niedzielska

Rudnicka–Drożak

2014

Open Medicine

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AbstractForeign-body aspiration in children results in diagnostic problems, mainly because of nonspecific signs. Therefore, in this study, we placed particular stress on false-positive and -negative predictors. Charts of 139 consecutive paediatric patients aged 6.0 months to 15.5 years who underwent bronchoscopy for a suspected foreign body aspiration were analysed retrospectively. A foreign body was found in 95 cases (68%). The anamnesis was positive in 91%. Cough was the most common clinical symptom (91%) with a sensitivity and specificity of 94% and 23%, respectively. There were no significant correlations between clinical symptoms and the locations of foreign bodies. The majority of focal hyperinflation (24%) and atelectasis (15%) were seen in chest radiographs, with a sensitivity and specificity of 33% and 89% (hyperinflation) and 15% and 82% (atelectasis), respectively. Chest X-rays were normal in 46 cases; however, an object was removed in 25. Persistent infiltrates were present in 14 X-rays, and a foreign body was extracted during bronchoscopy in 4. A highly significant correlation between the type of foreign body and radiological signs was noted (p = 0.00001). Anamnesis, clinical symptoms, and radiological findings are helpful in confirming aspiration, but can be misleading. Chronic or recurrent pneumonia should prompt further bronchoscopic diagnosis.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 79%

Diagnosis of paediatric airway foreign body: is it easy?

Rybojad¹,

Niedzielska

Rudnicka–Drożak

2014

Open Medicine

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“…A recent review article looking at use of RB for retrieval of airway foreign bodies found that bleeding occurred in 8−17% of cases. In addition, more serious complications including pneumothorax, airway perforation, cardiac arrest, and death have been reported (65).…”

Section: Rigid Bronchoscopymentioning

confidence: 99%

“…Various articles have quoted 7-46% negative bronchoscopy rates. Accordingly, recommendations and treatment algorithms have been suggested (65,66). In two recent studies, "obvious" cases of foreign body aspiration went directly to RB, and negative study results were still 14-18% (65,67,68).…”

Section: Rigid Bronchoscopymentioning

confidence: 99%

“…Accordingly, recommendations and treatment algorithms have been suggested (65,66). In two recent studies, "obvious" cases of foreign body aspiration went directly to RB, and negative study results were still 14-18% (65,67,68). Since flexible bronchoscopy is a quick and low risk procedure, the authors advocate for a diagnostic bronchoscopy prior to RB if the diagnosis of an aspirated foreign body is in doubt.…”

Section: Rigid Bronchoscopymentioning

confidence: 99%

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The role of bronchoscopy in the diagnosis of airway disease

Paradis¹,

Dixon²,

Tieu³

2016

J. Thorac. Dis.

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Endoscopy of the airway is a valuable tool for the evaluation and management of airway disease. It can be used to evaluate many different bronchopulmonary diseases including airway foreign bodies, tumors, infectious and inflammatory conditions, airway stenosis, and bronchopulmonary hemorrhage. Traditionally, options for evaluation were limited to flexible and rigid bronchoscopy. Recently, more sophisticated technology has led to the development of endobronchial ultrasound (EBUS) and electromagnetic navigational bronchoscopy (ENB). These technological advances, combined with increasing provider experience have resulted in a higher diagnostic yield with endoscopic biopsies. This review will focus on the role of bronchoscopy, including EBUS, ENB, and rigid bronchoscopy in the diagnosis of bronchopulmonary diseases. In addition, it will cover the anesthetic considerations, equipment, diagnostic yield, and potential complications.

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